Tehran University of Medical Sciences

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Development and Psychometric Validation of a Questionnaire to Assess Attitudes Toward Medical Law Reasoning (Mlraq) Publisher



Abdi M ; Norouzi A ; Mafinejad MK
Authors

Source: International Journal of Clinical Practice Published:2025


Abstract

Background: Attitude toward medical law reasoning is the first step in improving medical law reasoning skills in physicians. Despite its importance, no validated instrument currently exists to assess it. This study aimed to develop and validate a Medical Law Reasoning Attitude Questionnaire (MLRAQ) in medical students. Methods: The MLRAQ was developed based on the seven steps of AMEE Guide No. 87, related to designing questionnaires for educational research. In the first step, relevant articles were extracted through a systematic search. In the second step, medical law micro-skills were explored through a qualitative study by conducting 20 interviews. In the third and fourth steps, the identified medical law micro-skills were compared conceptually with previous studies, and the MLRAQ items were developed. Finally, content validity, cognitive interview, exploratory factor analysis, confirmatory factor analysis, and reliability analysis were performed in the fifth to seventh steps. Results: MLRAQ consists of five factors and 24 items. The validation results showed that the content validity index (CVI) and content validity ratio (CVR) were greater than 0.90. Five subscales (prerequisites, problem identification, application of rule, analysis, and conclusion) explained 67.26% of the variance in exploratory factor analysis. Cronbach’s alpha = 0.894, indicating high internal consistency. ICC = 0.771–0.942, demonstrating strong reliability across measurements. In confirmatory factor analysis, SRMR and RMSEA were 0.078 and 0.058, respectively. GFI was 0.880, and CFI was 0.901, indicating acceptable fit indices. Conclusion: The MLRAQ demonstrated valid and reliable evidence. Therefore, this instrument can assess attitudes toward medical law reasoning. © 2025 Elsevier B.V., All rights reserved.
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